LARS M ELLISON (NPI# 1114902749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114902749 |
| Entity Type | Individual |
| Full Name | LARS M ELLISON |
| Credential | M.D. |
| Practice Address |
3 Glen Cove Dr Rockport ME 04856-4232 |
| Practice Telephone | 2075935400 |
| Practice Fax Number | 2075935301 |
| Mailing Telephone | 2075935400 |
| Mailing Fax Number | 2075935301 |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | A83598 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
3 GLEN COVE DR |
| City | ROCKPORT |
| State | ME |
| Zip Code | 04856-4232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033552054 | Eve K Hadley | Advanced Practice Midwife | 3 Glen Cove Dr, Suite 1, Rockport, ME 04856-4232 | 2013-04-09 |
| 1598028839 | Wendelanne Augunas | Counselor | 3 Glen Cove Dr, Rockport, ME 04856-4232 | 2012-06-21 |
| 1417057340 | Elizabeth A Tulip | Physician Assistant | 3 Glen Cove Dr, Rockport, ME 04856-4232 | 2006-09-22 |
| 1447350301 | Clara B Buescher | Advanced Practice Midwife | 3 Glen Cove Dr, Rockport, ME 04856-4232 | 2006-09-22 |
| 1831297803 | Martyn A Vickers Jr. | Urology | 3 Glen Cove Dr, Rockport, ME 04856-4232 | 2006-09-21 |
| 1104923077 | Marian Lynne Frey | Advanced Practice Midwife | 3 Glen Cove Dr, Rockport, ME 04856-4232 | 2006-09-20 |
| 1467559336 | Susan E Harris | Advanced Practice Midwife | 3 Glen Cove Dr, Rockport, ME 04856-4232 | 2006-09-20 |
| 1952408635 | Katherine A Killoran | Obstetrics & Gynecology | 3 Glen Cove Dr, Rockport, ME 04856-4232 | 2006-09-17 |
| 1699872374 | Thomas J. O'connor IIi | Obstetrics & Gynecology | 3 Glen Cove Dr, Rockport, ME 04856-4232 | 2006-09-17 |
| 1497799720 | Penobscot Bay Physicians & Associates | Clinic/Center | 3 Glen Cove Dr, Suite 2, Rockport, ME 04856-4232 | 2006-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881171585 | Lisa Manley | Physical Therapist | 6 Glen Cove Drive, Pbmc, Rockport, Me, ME 04856 | 2018-07-25 |
| 1871096834 | Brenda K Berry | Registered Nurse | 731 Commercial Street, Rockport, ME 04856 | 2018-03-15 |
| 1174908495 | Atlantic Behavior Services, Inc | Behavioral Analyst | 112 Union Street, Rockport, ME 04856 | 2015-07-28 |
| 1326451212 | Abigail Bernett Ryan | Clinical Neuropsychologist | 220 Union St, Rockport, ME 04856 | 2014-06-09 |
| 1790024438 | Michelle Gallant | Dental Hygienist | 37 Chickawaukie Pond Rd, Rockport, ME 04856 | 2013-01-31 |
| 1316221666 | Nancy K Alexander | Advanced Practice Midwife | 3 Glen Cove Dr Ste 1, Rockport, ME 04856 | 2011-10-05 |
| 1619283793 | Karen Canfield | Social Worker | 41 Forsest St, Rockport, ME 04856 | 2010-08-26 |
| 1518283530 | Kendra Emery | Family Medicine | 7 Madelyn Ln Ste 200, Rockport, ME 04856 | 2010-04-15 |
| 1598999369 | Patricia L. Kristiansen | Occupational Therapy Assistant | 6 Madelyn Lane, Rockport, ME 04856 | 2009-05-08 |
| 1801020797 | Tiffany Ann Darge | Dental Hygienist | 1060 Commercial St., Rockport, ME 04856 | 2009-05-07 |
| Find all providers in zip 04856 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124080445 | Elizabeth A Albertson | Urology | 3 Glen Cove Dr # 3, Rockport, ME 04856-4232 | 2006-04-03 |
| 1831297803 | Martyn A Vickers Jr. | Urology | 3 Glen Cove Dr, Rockport, ME 04856-4232 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942614979 | Marc Calabrese | Urology | 21 Donald B Dean Dr Ste 1, South Portland, ME 04106-3234 | 2014-06-18 |
| 1144507948 | Andrew Percy Iverson,md II | Urology | 11 Staples Point Rd, Freeport, ME 04032-6003 | 2011-11-08 |
| 1063640555 | Curtis P. Ross | Urology | 55 Broadway Ste 2, Bangor, ME 04401-5201 | 2009-06-23 |
| 1790928570 | Evan J Dunn | Urology | 287 Main St Ste 404, Lewiston, ME 04240-7056 | 2009-04-09 |
| 1659534782 | Jonas Gricius | Urology | 55 Broadway Fl 2, Bangor, ME 04401-5201 | 2008-07-09 |
| 1639260847 | Derrick S Tooth | Urology | 1053 Western Ave, Manchester, ME 04351-3403 | 2006-09-27 |
| 1093806200 | Joseph Flannery Lopes | Urology | 9 Pleasant Street, Suite 2, Oakland, ME 04963 | 2006-09-27 |
| 1720013204 | John Russell | Urology | 22 Hartford St # Sr, Houlton, ME 04730-1844 | 2006-07-12 |
| 1649226655 | Moritz H Hansen | Urology | 100 Brickhill Avenue, South Portland, ME 04106 | 2006-05-25 |
| 1285692392 | James W Ross | Urology | 85 Baribeau Drive, Brunswick, ME 04011 | 2006-05-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.